For this week's excerpt, I'm sharing part of an early chapter of Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety. Alcoholics drink that first drink for many of the same reasons non-alcoholics do: among the reasons is to relieve stress. Non-alcoholics can stop, alcoholics cannot, after the first drink. Chapter Two covers stress and cortisol and their relation to relapse, plus the new research revealing how the stress hormone alters the perception of and reaction to stress in those with the disease of alcoholism.
"The stressors Alcoholics pile up over periods of sobriety aren’t the small day-by-day stressors like coffee spills on new carpet. They’re the four major category stressors covered in chapters four through seven. The longer you spend in prolonged stress with the cortisol rioting through you, the more intense your feelings of helplessness and, sometimes, emotional numbness. You at times feel like you’re just going through the motions. Things “normal” people drink to forget.
Adrenals, like the rest of the body, are not designed for prolonged stress according to Dr. Aphrodite Matsakis (I Can’t Get Over It, New Harbinger Publications, Oakland, CA 1992). “The adrenals can be permanently damaged leading to overfunctioning during subsequent stress. If you were subjected to repeated or intense trauma or stress, certain biochemicals may have been depleted.”
In a famous series of experiments conducted by Martin Seligman in the 1970s, animals were subjected to electrical shocks they could not flee no matter what they did or did not do (Helplessness: On Depression, Development and Death, W.H. Freeman, San Francisco, CA 1975). They fought at first. Later the animals became listless when shocked. This was phase one. In Seligman’s second phase, the animals were shocked again but could prevent the zap by pressing a button. They didn’t. They were too changed biochemically to take a simple action to end their suffering. Bessel van der Kolk (in Journal of Traumatic Stress, Vol. 1, 1988) followed up the Seligman work and concluded the shocked creatures had the same biochemical imbalances as humans enduring prolonged exposure to stressors. With people though, human nature dictates that we try to avoid or escape anything to do with the stressor. Someone might, for example, avoid driving a car after the stress of a car wreck. That is a single, short-duration stressor. An Alcoholic, like Seligman’s experiment subjects, has multiple stressors of long duration. And you can’t run from them all. Like the two experiments convincingly demonstrated, there’s a point at which we don’t even save ourselves. Alcohol becomes an efficient escape.
Initially as we begin abstinence, we’re told to save ourselves from triggers. People. Places. Things. And the things in slogan-happy and acronym-rich rehab we call HALT: being Hungry, Angry, Lonely or Tired. Research demonstrates that those triggers lead to lapse because you are not thinking your clearest thoughts. When your stomach growls the oldest parts of the brain focus your body’s resources on food. If you’re focused on food, you’re not focused on sobriety, the thinking goes. You’re juggling sobriety’s apples and hunger throws you a chainsaw. When you’re tired, your thinking is blunted by your need for sleep. When you’re angry or lonely, you may prioritize resolving those emotions rather than concentrating on sobriety. HALT is a good starting point. The objective is to stay out of harm’s way. Avoid. But the four major stressors knocking our cortisol out of whack and leading to lapse, you cannot avoid. We need to instead alter our reactions to them.”
– from Every Silver Lining Has a Cloud, pages 29-30, FIVE STARS on amazon.comThe first drink is the ESC key for the big stressors in the book, even for infrequent drinkers. Alcohol has managed to remain popular for millennia for that reason despite troubling social or physical outcomes from alcohol misuse. For non-alcoholics, stopping after that first drink, after hitting the ESC key, isn't an issue. All bets are off for the Alcoholic after the first drink to break the stress. That isn't to say violence or illness is inevitable for that episode, just that stopping at one is not an option. Many drinkers have tried and failed that simple test. After the first one, it's like trying to slam a revolving door.